Organization Active NPI

Platte Valley Medical Group, LLC

Doing business as Intermountain Health Brighton Clinic

  • Family Medicine Physician
  • Brighton, CO
National Provider Identifier
1275283574
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PLATTE VALLEY MEDICAL GROUP, LLC
Doing business as
Intermountain Health Brighton Clinic
Practice address
217 N 50TH Ave
Brighton, CO 80601-8364
Phone
(303) 659-1152
Fax
(720) 685-0027
NPI assigned
Mar 28, 2022
Last updated
May 15, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BRIGHTON COMMUNITY HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jon McDaniel
Title
VP Finance
Phone
(303) 272-0231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

217 N 50TH Ave
Brighton, CO 80601-8364

Mailing address

500 Eldorado Blvd Ste 4300
Broomfield, CO 80021-3564

Other names 1

  • Intermountain Health Brighton Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180112000840 CO Part B Supplier - Clinic/Group Practice 5890054100 Receives reassigned benefits from 201 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brighton, CO; Thornton, CO; Fort Lupton, CO; Denver, CO; Commerce City, CO

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Platte Valley Medical Group LLC15 organizations share this tax ID, including this one
Part of
Brighton Comm Hosp Assn

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1275283574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ELDORADO BLVD STE 4300",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 N 50TH AVE",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806018364",
            "telephone_number": "303-659-1152",
            "fax_number": "720-685-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATTE VALLEY MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIGHTON COMMUNITY HOSPITAL ASSOCIATION",
        "enumeration_date": "2022-03-28",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "303-272-0231"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Health Brighton Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.